Pacemaker failure caused by traveller's diarrhoea.

Area of Science:

• Cardiology
• Electrophysiology
• Internal Medicine

Background:

• Pacemaker dependency in patients with cardiac conditions.
• Potential complications of gastrointestinal infections in pacemaker patients.
• Electrolyte imbalances and their impact on cardiac function.

Observation:

• A female patient with a VVI pacemaker presented with symptoms of traveller's diarrhea.
• The patient developed arrhythmia, pacemaker failure, and severe hyponatremia (117 mmol/l).
• Treatment involved intravenous sodium chloride substitution.

Findings:

• The patient's arrhythmia and pacemaker failure were directly linked to severe hyponatremia.
• Sodium chloride substitution led to the remission of symptoms.
• Pacemaker electrocardiogram (ECG) normalized after electrolyte correction.

Implications:

• Highlights the critical role of electrolytes, particularly sodium, in maintaining cardiac rhythm and pacemaker function.
• Underscores the importance of monitoring electrolyte levels in pacemaker patients with gastrointestinal disturbances.
• Suggests prompt electrolyte management can prevent severe cardiac events and pacemaker malfunction.